POS0795-HPR STAGE 1 HYPERTENSION CARRIES EXCESSIVE CARDIOVASCULAR RISK IN AXIAL SPONDYLOARTHRITIS PATIENTS: A 12-YEAR LONGITUDINAL COHORT STUDY
Authors: J. L. H. Shi, H. So, S. H. M. Lam, T. K. Li, E. Li, C. C. Szeto, L. S. Tam
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Hypertension (HT) is one of the modifiable risk factors for the development of CV event (CVE) [1,2]. The American College of Cardiology/American Heart Association (ACC/AHA) recommended a new definition for arterial HT in adults since 2017 [3]. Whether this new definition of HT is associated with increased CV risk in patients with axSpA remains unknown. <h3>Objectives</h3> To ascertain whether stage 1 hypertension at baseline is a predictor of future cardiovascular event (CVE) in patients with axial spondyloarthritis (axSpA). <h3>Methods</h3> We conducted a retrospective cohort study in axSpA patients who were recruited from 2001-2017. Patients with at least 2 years of follow-up and without prior CVE were divided into three groups according to the calculated mean BP over the first 2-year period (adjusted mean BP) (≥140/90mm Hg, 130-139/80-89mm Hg and &lt;130/80mm Hg). They were followed from baseline until the end of 2020 or occurrence of a first CVE. Multivariate Cox regression analyses adjusting for baseline and time-varying variables were used to assess the relationship between mean BP and with CVE. <h3>Results</h3> Out of the 458 patients fulfilling the inclusion criteria, 56 (12.2%) and 141 (30.8%) had an adjusted mean BP ≥140/90mm Hg and 130–139/80–89mm Hg respectively, and 261 (57.0%) were normotensives. After a median follow-up of 12 [7-18] years, 56 (12.2%) CVE were documented. The incidence rates were 21.4, 14.2 and 5.9 per 1000 patient-years for the three groups respectively. A adjusted mean BP of 130–139/80–89 mm Hg was independently associated with the occurrence of CVE after adjusting for the baseline covariates (Figure 1) as well as time-varying inflammatory burden (Table 1). This association was not significant after adjustment for time-varying traditional CV risk factors. <h3>Conclusion</h3> Stage I hypertension at baseline is associated with increased risk of developing CVE in axSpA patients. This association may be mediated by other traditional CV risk factor.s. <h3>References</h3> [1]Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364(9438):937-52. [2]Lim SS, Vos T, Flaxman AD, Danaei G, Shibuya K, Adair-Rohani H, et al. A comparative risk assessment of burden of disease and injury attributable to 67 risk factors and risk factor clusters in 21 regions, 1990-2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012;380(9859):2224-60. [3]Whelton PK, Carey RM, Aronow WS, Casey DE, Jr., Collins KJ, Dennison Himmelfarb C, et al. 2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Circulation. 2018;138(17):e484-e594. <h3>Acknowledgements</h3> I would acknowledge all the supports from our teammates. <h3>Disclosure of Interests</h3> None Declared.